From: Reliability of team-based self-monitoring in critical events: a pilot study
 | Use the following scale to rate the team on each dimension: | 0 = never/rarely | 1 = inconsistently | 2 = consistently | na = not applicable | |||
---|---|---|---|---|---|---|---|---|
1 | Do you feel that the leader was recognized by all team members? | Â | Â | Â | 0 | 1 | 2 | na |
2 | Do you think the leader assured maintenance of an appropriate balance between command authority and team member participation? | Â | Â | Â | 0 | 1 | 2 | na |
3 | Do you feel that each team member prompted each other to attend to all significant clinical indicators throughout the scenario? | Â | Â | Â | 0 | 1 | 2 | na |
4 | Do you think team members prompted each other to attend to all significant clinical indicators throughout the scenario? | Â | Â | Â | 0 | 1 | 2 | na |
5 | Do you think team members verbalized their activities loud when they were actively involved with the patient? | Â | Â | Â | 0 | 1 | 2 | na |
6 | Do you feel that team members repeated back or paraphrased instructions and clarifications to indicate that they heard them correctly? | Â | Â | Â | 0 | 1 | 2 | na |
7 | Do you feel that disagreement or conflicts among team members were addressed without a loss situation awareness? | Â | Â | Â | 0 | 1 | 2 | na |
8 | Do you think roles were shifted to address urgent or emergent events when appropriate? | Â | Â | Â | 0 | 1 | 2 | na |
9 | Do you think team members responded to potential errors or complications with procedures that avoided the error or complication? | Â | Â | Â | 0 | 1 | 2 | na |